Eye Exams and Eye Tests for Dyslexia

Binocular vision problems with eye teaming coordination and/or focusing often occur with or can be mistaken
for dyslexia. These symptoms can be successfully treated with vision therapy eye exercises, so a comprehensive
binocular eye exam is recommended before making the diagnosis of dyslexia or providing other treatments,
such as colored lenses.
Optometric Assessment and
Management of Dyslexia
Frank Eperjesi BSc, PhD, MCOptom, FAAO
Dyslexia has been described as a language coding problem1 and can be considered to be synonymous with the
term specific reading problem. It is not related to social, emotional, economic or obvious disease (e.g. Down's
syndrome) problems and can only be diagnosed by an educational or child psychologist. There may be a
difficulty with reading, spelling, understanding Language that is heard, and clear expression when speaking or
writing. Some sufferers may have difficulty with speaking clearly or with handwriting. Others have difficulty
with right and Left or the concept of before and after. Others may have less severe or even mild difficulty in one
or two other areas such as organising. Some have additional problems such as attentional deficits. No two
dyslexics are alike: each has individual strengths and weaknesses2.
An unexpected gap exists between the potential for learning and school achievement. i.e. their academic skills
are 'out of step' with their general ability. It is important to remember that not all have problems with reading 3.
It is a medical problem and is considered to be caused by a 'minimal brain dysfunction', also described as a
differential brain function. Rosen et al4noted that there can be one or more (up to fifty) affected sites or Lesions
in the brain, in which small cortical areas have abnormally arranged cells.
Research has indicated that up to 15% of the population may be dyslexic and that fewer than one in ten will
actually be identified as needing help and be able to receive formal diagnosis. A proportion will overcome early
difficulties but for the majority learning difficulties are likely to persist and to have deleterious consequences on
their later careers2.
People are born with dyslexia and often other members of the family are dyslexic or have a difficulty learning to
read and spell. Dyslexia is not out grown, although most dyslexics develop coping strategies (e.g. avoiding
reading). Dyslexics may have a wide range of talents, for example in art, drama, maths and sports, yet they may
have difficulty remembering things or organising themselves2.
This article will concentrate on the optometric assessment and management of those who have dyslexia but the
techniques described are equally valid for anyone who is under achieving at school or work whether they are
formerly diagnosed as dyslexic or not.
Vision has been defined as a continuous and integrative process that can be divided into three components: (1)
visual acuity, including refractive status; (2) visual efficiency, which is composed of oculomotor,
accommodative and binocular vision skills; and (3) visual perceptual-motor skills, which represent the ability to
recognise and discriminate visual stimuli and interpret them correctly in the light of previous experience3. While
it is recognised that all of these components are equally important the emphasis will be placed on visual
efficiency

Vision problems and dyslexia

A useful model has been put forward in an attempt to relate vision problems, dyslexia and other general
problems1 (Figure 1). A general reading problem due mainly to vision problems, such as high, uncorrected
hyperopic astigmatism would fall into circle 1. An individual with dyslexia and a concurrent vision problem
would fall into area 4. From the diagram it can be seen that optometric evaluation would be useful for those
people who fall into circle l and in particular areas indicated by and in particular areas indicated in Figure 1 by
4, 5 and 7.
Visual disorders such as hyperopia, convergence insufficiency, poor fusional vergence reserves, fixation
disparity, hyperphoria, anisometropia, accommodative dysfunctions. among other dysfunctions have been
shown to adversely affect reading performance and sustainability23.
This article will focus on the assessment of vergence and accommodative ability and the management of
vergence and accommodative dysfunction. The assessment techniques and management strategies described
below are not intended to be prescriptive or in any way describe a gold standard; there will be other tests and
management lines that practitioners will use and consider better than those described here. The protocol
described here was learnt and adopted by the author by combining experience obtained from the Specific
Learning Difficulties Clinic at the Institute of Optometry, from general optometric practice and from
information obtained from the literature (see below for a List of useful texts). Information on the assessment
and management of saccadic and pursuit eye movements and fixation can be obtained from Griffin et al1.
Visual perceptual distortions and symptoms
Some children and adults, who have difficulty with reading, experience visual perceptual distortion and
complain of asthenopic symptoms when viewing a page of print. The Letters may appear to move, jumble or to
blur; white paper may glare and cause eyestrain or headaches. The resulting visual and physical discomfort is
very likely to interfere with reading, and often attention and concentration are reduced. These distortions can be
caused by a conventional optometric anomaly such as hyperopic astigmatism, a deficit in the binocular vision
system (reduced visual efficiency), by Meares-Irlen Syndrome or a combination of some or all of these.
Lightstone and Evans5have suggested a sequential assessment and management plan to determine the cause of
these signs and symptoms.
Meares-Irlen Syndrome
Visual perceptual distortions and asthenopic symptoms alleviated by individually prescribed coloured filters are
considered to be due to Meares-Irlen Syndrome6. These distortions and symptoms can occur quite
independently of any eye problem in people whose sight is otherwise perfect. Meares-Irlen Syndrome may be
due to pattern glare, which has been described as an over sensitivity to the stripy line pattern that dark print
makes on a white page7. This can occur in a person with or without dyslexia and probably does not cause

dyslexia but can however, hinder educational rehabilitation. Some people with specific reading and learning
difficulties may not voluntarily report experiencing these visual distortions and symptoms, and it is therefore
important to remember that it may take detailed and sensitive questioning from an experienced practitioner to
elicit these problems.
Binocular vision (visual efficiency) evaluation
The two main binocular vision related problems that occur are vergence and accommodative disorders. The
vergence and accommodative mechanisms must be functioning efficiently to facilitate accurate sustained and
reading. These two anomalies can occur together or independently and are amenable to treatment with lenses or
eye exercises. These are varied and are chosen to match the individuals age and specific problem.
Vergence disorders
Vergence disorders are very common in non-presbyopic subjects and can result in ocular discomfort, headaches,
diplopia, blurred vision and fatigue during reading and other near point tasks. Some subjects do not have
asthenopia because they avoid near-point tasks.
Conclusion
There is now no doubt that vision problems and in particular binocular vision anomalies can seriously affect the
ability to learn to read although it is also readily accepted that vision problems are not a direct cause of true
dyslexia. ALL children and adults who are reading or learning underachievers, whether a formal diagnosis of
dyslexia has been made or not, require a detailed evaluation of visual function, especially of the binocular
vision system, at an early stage in their remediation.
References
1. Griffin et al. (1997). Optometric Management of Reading Dysfunction. Butterworth-Heinemann,
Newton.
2. Prior, M. (1996). Understanding Specific Learning Difficulties. Psychology Press, Hove.
3. Garzia, R. P. (1996) Vision and Reading. Mosby, St Louis.
4. Rosen, G. D., Sherman, G. F.and Galaburda, A. M. (1993). Dyslexia and Brain Pathology: Experimental
Animal Models in Dyslexia and Development: Neurological Aspects of Extraordinary Brains (ed.) A. M.
Galaburda. Harvard College, Boston.
5. Lightstone, A. and Evans, B. J.W. (1995). A new protocol for the optometric management of patients
with reading difficulties. Ophthalmic and Physiological Optics. 15, 507-512.
6. Evans, B. J. W., Wilkins, A. J., Brown, J., Busby, A., Wingfield, A. E., Jeanes, R., and Bald, J. (1994). A
preliminary investigation into the aetiology of Meares-Irlen Syndrome. Ophthalmic and Physiological
Optics. 14, 365-370.
7. Wilkins, A. J (1995). Visual Stress. Oxford Science Publications, Oxford.
8. Simons, H. D. and Grisham, J. D. (1987). Binocular anomalies and reading problems. Journal of the
American Optometric Association. 58, 578-87.
9. Evans, B. J. W. (1997). Pickwell's Binocular Vision Anomalies: Investigation and Treatment.
Butterworth-Heinemann, Oxford.

10. Evans, B. J. W, Drasdo, N, and Richards, I. L. (1994). Investigation of accommodative and binocular
function in dyslexia. Ophthalmic and Physiological Optics. 1, 5-19.
11. O'Grady, J. (1984). The relationship between vision and educational performance: a study of year 2
children in Tasmania. Australian Journal of Optometry. 64, 126-40.
12. Griffin, J. R. and Gn'sham, J. D. (1995) Binocular Anomalies: Diagnosis and Vision Therapy (3rd ed).
Butterworth-Heinemann. Boston.
13. Mallett, R. F.J. (1964). The investigation of heterophoria at near and a new fixation disparity technique.
The Optician. 148, 547551.
14. Hoffman, L. G. and Rouse, M.W. (1980) Referral recommendations for binocular function and/or
developmental perceptual deficiencies. Journal of the American Optometric Association. 51. 119-125.
15.
15. Rundstrm. M. M. personal communication. 1995.
16. Adler, P.Instructions accompanying dinosaur card.
17. Evans B. J. W. (2000) Decompensated exophoria at near, convergence insufficiency and binocular
instability. Optician. 219, 20-28.
18. Scheiman, M. et al. (1996) Vergence facility establishment of clinical norms in a padiatric population.
Supplement to Optometry and Vision Science. 73. 135.
Useful reading
1. Optometric Management of Reading Dysfunction. Griffin. et al. (1997). Butterworth-Heinemann. ISBN
0-7506-9516-1 2.
2. Optometric Management of Learning-Related Vision Problems. (1995) Schieman and Rouse. Mosby.
ISBN 0-8151-6385-7.
3. Visual Stress. A.J. Wilkins. (1995). Oxford Science Publications , Oxford. ISBN O 19 852 174 X.
4. Pickwell's Binocular Vision Anomalies: Investigation and Treatment. (1997). B. J. W. Evans.
Butterworth-Heinemann, Oxford. ISBN O 7506 2062 5
Useful contacts
1. Kay Pictures, PO Box 380, Tring, Herts. HP23 5NL; dot cards and dinosaur cards.
2. Paul Adler, 50 High St., Stoffold, Hitchin, HERTS, SG5 4LL, tel. 01462 732393: dinosaur cards, Brock
strings, flipper bars without Lenses and 50V9 Suppression slide.
3. I00 Marketing Ltd Tel: 020-7378 0330 for IFS exercises.
http://www.optometrists.org/therapists_teachers/dyslexia_dyslexic_vision.html
Effective Evaluation and Treatment - - Improvements for Children and Adults with
Learning Disabilities, Vision Related Learning Problems and Difficulties Related to Vision
Find out what 100s of teachers, parents, children, and adult What is Optometric Vision Therapy?
patients say when asked "What changes have you seen as a Who wrote these Vision Therapy Success Stories?
result of a Vision Therapy program" or "How has Vision
Who is the publisher of this catalog?

Therapy changed your life?"

Learning Disabilities (LDs)
ADD-ADHD
Autism Spectrum Disorders
Dyslexia, Dyslexic
Gifted Learning Disabled
Nonverbal LD (NLD)
Special Education
Unspecified LD
Visual Disabilities
Amblyopia (Lazy Eye)
Brain Injury (TBI) - Concussions
Convergence Insufficiency
Improving Depth Perception
Getting Rid of Double Vision
Eye Tracking Problems
Attn:
Teachers
Nurses
Doctors
Therapists
Parents
Strabismus (Crossed Eyes)
Success in School
20/20 is Not Enough!
Better Grades & Honors
Homework, Spelling
Reading, Math,
Writing and Handwriting
Was Below Grade Level
Sports and Coordination
Hand-Eye Coordination & Sports
Motor Coordination & Sports
Fine Motor, Drawing & Puzzles
Music: Playing & Reading
Dizziness, Nausea, Headaches
Blurred or Blurry Vision
Dizziness, Nausea, Motion Sickness
Eye Strain, Eye Fatigue
Headaches
Called Dumb...Slow...Lazy...
Dumb, Stupid, Low IQ
Lazy! Not Trying...
Slow Learner
Improved Behavior
Fewer Tantrums
Self Confidence

Where can Vision Therapy providers be found?

Surgery for Lazy Eye

After Surgery
Without Surgery
Better Vision for Adults
It's Not Too Late!
http://www.visiontherapystories.org/

1. What is Dyslexia?
The word 'dyslexia' comes from the Greek and means 'difficulty with words'.
It is a life long, usually genetic, inherited condition and affects around 10% of the population.
Dyslexia occurs in people of all races, backgrounds and abilities, and varies from person to person: no
two people will have the same set of strengths and weaknesses.
Dyslexia occurs independently of intelligence.
Dyslexia is really about information processing: dyslexic people may have difficulty processing and
remembering information they see and hear. This can affect learning and the acquisition of literacy skills.
Dyslexia is one of a family of Specific Learning Difficulties. It often co-occurs with related conditions,
such as dyspraxia, dyscalculia and attention deficit disorder.
On the plus side, dyslexic people often have strong visual, creative and problem solving skills and are
prominent among entrepreneurs, inventors, architects, engineers and in the arts and entertainment world. Many
famous and successful people are dyslexic.
(Return to top

2. How it feels to be Dyslexic.

I see things from a different perspective.
I can come up with solutions no one else has thought of and I think fast on my feet.
When I am reading, occasionally a passage will get all jumbled up, but when it happens I have to read and reread the passage over again.
I know what I want to say, but I can never find the right words.
In formal situations, although I know what I want to say, I struggle, lose focus and then my mind goes blank
and I panic.'
I have the right ideas, but I cant get them down on paper.
Its like my computer crashing with too much information!
Sometimes when I am being told what to do, the words I hear get all jumbled up in my mind and I just cant
take in what is being said to me.
In general conversation with family, friends and colleagues they usually accept that I tend to ramble, forget and
repeat,. because thats part of me.
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3. Where to look for help.

Further information sheets in this section for Adults and Employers offer extensive information and details of
sources of advice.
(Return to top)

4. Advice and Information

Contact the B.D.A's National Helpline. The Helpline is completely free and confidential for all those who are in
touch with dyslexia for every age group.
All information, advice and signposting is completely confidential and impartial enabling the caller to make
important choices and decisions for themselves.
Some Local Dyslexia Associations have helpliners specialising in information for dyslexic adults. Others have
general helpliners who may be able to help with adult enquiries.
Assessment, Advice, Tuition.
There is a list of B.D.A. Organisational Members available. Some of these offer services to dyslexic adults.
They usually charge for these services.
(Return to top)

1.
2.
3.
4.
5.

5. Other sources of help.

The Disability Employment Advisor at your local Job Centre.
Adult Basic Education Centre.
C.A.B: Citizens' Advice Bureau.
Your council's Neighbourhood Office.
Your trade union, if applicable.
Your local Disability Information Service (http://www.dialuk.info)
British Telecom services.
Free Directory Enquiries is a service for anyone who is unable to use a Telephone Directory easily. It is
available to people with dyslexia.
For registration details call free on Tel: 195.
Email discussion group.
This is a dyslexia forum and includes discussions by and for dyslexic people.
http://www.bdadyslexia.org.uk/dyslexic/dyslexia-and-specific-difficulties-overview
On this page you will find information regarding:
Visual Stress.
Finding a specialist practitioner.
Resources.
Computer aids for visual stress.
Further reading.
Visual Stress.
People with visual stress may experience one or several of the following:
Blurred letters or words which go out of focus.
Letters which move or present with back to front appearance or shimmering or shaking.
Headaches from reading.
Words or letters which break into two and appear as double.
Find it easier to read large, widely spaced print, than small and crowded.
Difficulty with tracking across the page.
Upset by glare on the page or oversensitive to bright lights.
In some cases any of these symptoms can significantly affect reading ability. It can also make reading very
tiring. Of course a child will not necessarily recognise what they see as a problem, as this is how they always
see text.

If a child complains of a least one of these problems or has difficulty at school, they should be referred to an
optometrist or orthoptist with expertise in this particular field (see contact details below). Many dyslexic people
are sensitive to the glare of white backgrounds on a page, white board or computer screen. This can make the
reading of text much harder.
The use of cream or pastel coloured backgrounds can mitigate this difficulty as can coloured filters
either as an overlay or as tinted reading glasses. - People with reading difficulties sometimes have a weakness in
eye co-ordination or focussing and an specialist practitioner might recommend treating this with eye exercises
or glasses. If these problems are present, they should be detected and treated before coloured filters are
prescribed.
The choice of colour of text on white backgrounds can also affect clarity e.g. using red on a whiteboard
can render the text almost invisible for some dyslexic students. For information on dyslexia friendly text
see Dyslexia Style Guide.
An exmaple of visual stress:

(Return to top)
Finding a specialist practitioner.
You are advised to ensure that any practitioner is properly trained and qualified in this area.
Aston University (Birmingham) Optometry Depatrment.
Not for profit Learning and Vision Clinic.
Tel: 0121 204 3900
Email: eyecare@aston.ac.uk
Web: http://www1.aston.ac.uk/lhs/health-clinics/optometry/children-binocular/
Bradford University Optometry Eye Clinic.
Free initial assessment for visual stress.
Tel: 01274 234649
Web:http://www.bradford.ac.uk/student/healthy-students/the-eye-clinic/visual-stress-clinic/
British Association of Behavioral Optometrists (BABO).
Ask for your nearest accredited behavioural optometrist or see list online.
Tel: 029 2022 8144
Email: admin@babo.co.uk
Web: http://www.babo.co.uk

Dyslexia Research Trust have Eye Clinics in Reading and Oxford.

Tel: 0118 958 5950
Web: www.dyslexic.org.uk
A leading research organisation into the visual aspects of dyslexia.
The Institute of Optometry.
Runs courses for teachers and eyecare practitioners about vision and reading difficulties and has a clinic for
people with reading problems.
Tel: 020 7407 4183
Fax: 020 7403 8007
Email: admin@ioo.org.uk
Web: http://www.ioo.org.uk.
Local Dyslexia Associations.
Contact your Local Dyslexia Association for recommendations of suitable local practitioners.
NHS.
Contact your GP for a referral to an appropriate specialist. In some hospitals the orthoptist may have expertise
in this field.
University Optometry Departments.
It would be worth contacting Optometry Departments of universities to see if they offer a service of
assessments.
Society for Coloured Lens Providers.
A list of recommended practitioners following an agreed code of conduct.
Web: http://www.s4clp.org
Visual Perception Unit, University of Essex.
Information on Colour in the Treatment of Visual Stress, references to practitioners and suppliers.
Tel: 01206 872 381
Web: http://www.essex.ac.uk/psychology/overlays

Computer aids for visual stress.

Monitor overlays are available in different shades and sizes which are held onto the screen by static.
Available from the BDA Shop.
http://www.bdadyslexia.org.uk/dyslexic/eyes-and-dyslexia
Dyslexia is a hidden disability thought to affect around 10% of the population, 4% severely. It is the most
common of the Specific Learning Difficulties, a family of related conditions with considerable overlap or cooccurrence. Together these are believed to affect around 15% of people to a lesser or greater extent.
Specific Learning Difficulties (SpLDs) affect the way information is learned and processed. They are
neurological (rather than psychological), usually hereditary and occur independently of intelligence. They
include:
Dyslexia
Dyspraxia or Development Co-ordination Disorder
Dyscalculia
Attention Deficit Disorder

Dyslexia.

Contrary to popular misconception, Dyslexia is not only about literacy, although weaknesses in literacy are
often the most visible sign. Dyslexia affects the way information is processed, stored and retrieved, with
problems of memory, speed of processing, time perception, organisation and sequencing.
Dyspraxia
Developmental Coordination Disorder (DCD), also known as Dyspraxia in the UK, is a common disorder
affecting fine and/or gross motor coordination in children and adults. This condition is formally recognised by
international organisations including the World Health Organisation. DCD is distinct from other motor disorders
such as cerebral palsy and stroke. The range of intellectual ability is in line with the general population.
Individuals may vary in how their difficulties present; these may change over time depending on environmental
demands and life experience, and will persist into adulthood.
An individuals coordination difficulties may affect participation and functioning of everyday life skills in
education, work and employment. Children may present with difficulties with self-care, writing, typing, riding a
bike, play as well as other educational and recreational activities. In adulthood many of these difficulties will
continue, as well as learning new skills at home, in education and work, such as driving a car and DIY. There
may be a range of co-occurring difficulties which can also have serious negative impacts on daily life. These
include social emotional difficulties as well as problems with time management, planning and organisation and
these may impact an adults education or employment experiences.
Dyscalculia
Dyscalculia is characterised by an inability to understand simple number concepts and to master basic numeracy
skills. There are likely to be difficulties dealing with numbers at very elementary levels; this includes learning
number facts and procedures, telling the time, time keeping, understanding quantity, prices and money.
Difficulties with numeracy and maths are also common with dyslexia.
ADHD/ADD.
Signs of Attention Deficit (Hyperactivity) Disorder include inattention, restlessness, impulsive, erratic,
unpredictable and inappropriate behaviour, blurting out inappropriate comments or interrupting excessively.
Some people come across unintentionally as aggressive. Most fail to make effective use of feedback.
If no hyperactivity is present, the term Attention Deficit Disorder should be used: these individuals have
particular problems remaining focused so may appear 'dreamy' and not to be paying attention. People with this
condition are very easily distracted, lose track of what they are doing and have poor listening skills. By failing
to pay attention to details, they may miss key points.
Autistic characteristics can co-exist with the conditions described above. Those affected often demonstrate
unusual behaviours due to inflexible thinking, over-reliance on routines, a lack of social and communication
skills. People with Asperger Syndrome may have learned to largely conceal their problems but still find any
social interaction very challenging and panic easily when they cannot cope.
Since Specific Learning Difficulties are still not adequately understood in all schools many children and young
people slip through education unidentified and unsupported.
Terminology.
Be aware that similar terminology can lead to confusion. For example, the term 'Learning Difficulties' is
generally applied to people with generalised (as opposed to specific) difficulties who are of low intelligence and
often lack mental capacity.

Many people with Specific Learning Difficulties tend to refer to themselves as having a Specific Learning
Difference (both generally abbreviated to SpLDs), while others regard a label containing the word 'Learning' as
inappropriate when they are no longer in education.
Areas of typical difficulty for all Specific Learning Difficulties.
Information Processing.
Difficulties with taking in information efficiently (this could be written or auditory).
Slow speed of information processing, such as a 'penny dropping' delay between hearing something and
understanding and responding to it.
Memory.
Poor short term memory for facts, events, times, dates.
Poor working memory; i.e. difficulty holding on to several pieces of information while undertaking a
task e.g. taking notes as you listen, coping with compound questions.
Mistakes with routine information e.g. giving your age or the ages of your children.
Inability to hold on to information without referring to notes.
Communication skills.
Lack of verbal fluency and lack of precision in speech.
Word-finding problems.
Inability to work out what to say quickly enough.
Misunderstandings or misinterpretations during oral exchanges.
Over-loud speech (which may come across as aggressive) or murmuring that cannot be clearly heard.
Sometimes mispronunciations or a speech impediment may be evident.
Literacy.
Lateness or difficulty in acquiring reading and writing skills. Some dyslexic adults have severe literacy
problems and may be functionally illiterate.
Where literacy has been mastered, residual problems generally remain such as erratic spelling, difficulty
extracting the sense from written material, difficulty with unfamiliar words, an inability to scan or skim text.
Particular difficulty with unfamiliar types of language such as technical terminology, acronyms.
Sequencing, Organisation and Time Management.
Difficulty presenting a sequence of events in a logical, structured way.
Incorrect sequencing of number and letter strings.
Tendency to misplace items; chronic disorganisation.
Poor time management: particular difficulties in estimating the passage of time.
Direction and Navigation.
Difficulty with finding the way to places or navigating the way round an unfamiliar building.
Concentration.
Weak listening skills, a limited attention span, problems maintaining focus.
A tendency to be easily distracted, inability to remain focused.
Sensory Sensitivity.
A heightened sensitivity to noise and visual stimuli.
Impaired ability to screen out background noise or movement.
Sensations of mental overload / switching off.
Lack of awareness.
Failure to realise the consequences of their speech or actions.
Failure to take account of body language.
Missing the implications of what they are told or interpreting it over-literally.

Visual Stress.
Some people with dyslexic difficulties may experience visual stress when reading. Text can appear distorted and
words or letters appear to move or become blurred. White paper or backgrounds can appear too dazzling and
make print hard to decipher.
Example of Visual Stress:

Coping Strategies.
It must be emphasised that individuals vary greatly in their Specific Learning Difficulties profile. Key variables
are the severity of the difficulties and the ability of the individual to identify and understand their difficulties
and successfully develop and implement coping strategies.
By adulthood, many people with Specific Learning Difficulties are able to compensate through technology,
reliance on others and an array of self-help mechanisms - the operation of which require sustained effort and
energy. Unfortunately, these strategies are prone to break down under stressful conditions which impinge on
areas of weakness.
Effects of stress.
Research and self-reporting both concur that people with Specific Learning Difficulties are particularly
susceptible to stress, compared with the ordinary population, with the result that their impairments become even
more pronounced. As a result of their difficulties, many people with Specific Learning Difficulties have little
confidence and low self-esteem.
Areas of Strength.
On the positive side, Specific Learning Difficulties are also linked to a range of skills. These include 'big
picture' thinking, problem-solving and lateral thinking abilities, an instinctive understanding of how things
work, originality, creativity and exceptional visual-spatial skills.
Famous individuals with Specific Learning Difficulties include Einstein, Churchill, JFK, Agatha Christie,
Richard Branson, James Dyson, Sir Jackie Stewart, leading artists, architects, engineers, entrepreneurs,
sportsmen and many stars of stage and screen.
Not all people with dyslexia and related difficulties will have outstanding talents, but all will have comparative
strengths and often demonstrate great perseverance and determination.
http://www.bdadyslexia.org.uk/dyslexic/dyslexia-and-specific-learning-difficulties-in-adults

Youre musical and youre dyslexic?

Do some people say youre just thick?
Oh no! Not at all!!
Its not a downfall
There are things that can help you real quick!

Yes! Dyslexia can affect music. You/your student/your family member or friendmay have difficulties with
things such as:

Sight reading music.

Remembering instructions in lessons and/or aural work.
De-coding information in music theory or exams, for example.
Organisation of things like attending instrumental or voice lessons, going to rehearsals, having the right
stuff, practicing alone
However, some people dont have any of these problems, but may react to dyslexia in their own unique ways.
But there are things that can be done!
For example:

Find a teacher who understands dyslexia.

Look at alternatives such as different (or no) exams; choice of instrument etc. Is music reading really
necessary?
If exams are necessary, there are reasonable adjustments that can be made to make life easier.
Use multi-sensory approaches in as many areas as possible. For example: use colour, pictures,
demonstration, listening to explanations, recordings, discussion, written text (yes some dyslexic people like
it!), hands-on exploration and so on. Music is good for this as it involved DOING. Decide what works
for you or your student.
See whether there may be a problem with seeing music on the page. If text or music seems to swirl
around, visual stress could be a problem. See our pages on Eyes and Dyslexia.

It can be important for some dyslexic musicians to get a whole picture of a piece before working on it
in detail.
There are various books available e.g. Music, other Performing Arts and Dyslexia published by the
B.D.A.
Further resources
Music and inclusive teaching (information booklet)
Top Ten Tips
A Pianist's Story
Our latest newsletter - February 2015
Practical Solutions for Music Learning course
The BDA also run a Practical Solutions for Music Learning course, for professionals wishing to gain a better
understanding of the area. For more information please download the course overview from this link.
http://www.bdadyslexia.org.uk/educator/music-and-dyslexia
WHAT ARE SPECIFIC LEARNING DIFFICULTIES?
Specific Learning Difficulties (or SpLDs), affect the way information is learned and processed. They are
neurological (rather than psychological), usually run in families and occur independently of intelligence. They
can have significant impact on education and learning and on the acquisition of literacy skills.
SpLD is an umbrella term used to cover a range of frequently co-occurring difficulties, more commonly:

Dyslexia.
Dyspraxia / DCD.
Dyscalculia.
A.D.D / A.D.H.D.
SpLDs can also co-occur with difficulties on the autistic spectrum such as Asperger Syndrome.
Be aware that similar terminology can lead to confusion. For example, the term Learning Difficulties is
generally applied to people with global (as opposed to specific) difficulties, indicating an overall impairment of
intellect and function.
In general, a student may be diagnosed with a SpLD where there is a lack of achievement at age and ability
level, or a large discrepancy between achievement and intellectual ability.
An untrained observer may conclude that a student with a SpLD is lazy, or just not trying hard enough. For
example they may find it difficult understanding the large discrepancy between reading comprehension and
proficiency in verbal ability, or between reading level and poor written work. The observer only sees the input

and output, not the processing of the information. Deficiencies in the processing of information can make
learning and expressing ideas difficult or impossible tasks.
Because of the high level of co-occurrence between different SpLDs, it is important to understand that each
profile is unique to the individual and can appear in a variety of ways. The effects of a SpLD are manifested
differently for different students and range from mild to severe. It may be difficult to diagnose, to determine
impact, and to accommodate.
Unidentified and unsupported dyslexia and related conditions can lead to emotional distress, frustration and
poor self-esteem. This can result in a child becoming withdrawn, or more commonly to develop behavioural
issues. Rather than focusing on behavioural problems, schools would be advised instead to address the possible
underlying causes, which in many cases may be previously undiagnosed specific learning difficulties.
Types of Specific Learning Difficulty
Dyslexia:
Dyslexia is a hidden disability thought to affect around 10% of the population, 4% severely. It is the most
common of the SpLDs. Dyslexia is usually hereditary. A student with dyslexia may mix up letters within words
and words within sentences while reading. They may also have difficulty with spelling words correctly while
writing; letter reversals are common. However Dyslexia is not only about literacy, although weaknesses in
literacy are often the most visible sign. Dyslexia affects the way information is processed, stored and retrieved,
with problems of memory, speed of processing, time perception, organisation and sequencing. Some may also
have difficulty navigating a route, left and right and compass directions.

Dyspraxia / DCD:
Developmental Coordination Disorder (DCD), also known as Dyspraxia in the UK, is a common disorder
affecting fine and/or gross motor coordination in children and adults. This condition is formally recognised by
international organisations including the World Health Organisation. DCD is distinct from other motor disorders
such as cerebral palsy and stroke. The range of intellectual ability is in line with the general population.
Individuals may vary in how their difficulties present; these may change over time depending on environmental
demands and life experience, and will persist into adulthood. An individuals coordination difficulties may
affect participation and functioning of everyday life skills in education, work and employment. Children may
present with difficulties with self-care, writing, typing, riding a bike, play as well as other educational and
recreational activities. In adulthood many of these difficulties will continue, as well as learning new skills at
home, in education and work, such as driving a car and DIY. There may be a range of co-occurring difficulties
which can also have serious negative impacts on daily life. These include social emotional difficulties as well as

problems with time management, planning and organisation and these may impact an adults education or
employment experiences.
Dyscalculia:
Is a difficulty understanding maths concepts and symbols. It is characterised by an inability to understand
simple number concepts and to master basic numeracy skills. There are likely to be difficulties dealing with
numbers at very elementary levels; this includes learning number facts and procedures, telling the time, time
keeping, understanding quantity, prices and money. Difficulties with numeracy and maths are also common with
dyslexia.
A.D.H.D / A.D.D.
Signs of Attention Deficit (Hyperactivity) Disorder include inattention, restlessness, impulsivity, erratic,
unpredictable and inappropriate behaviour, blurting out inappropriate comments or interrupting excessively.
Some students come across unintentionally as aggressive. Most fail to make effective use of feedback. If no
hyperactivity is present, the term Attention Deficit Disorder should be used: these individuals have particular
problems remaining focused so may appear 'dreamy' and not to be paying attention. Students with this condition
are very easily distracted, lose track of what they are doing and have poor listening skills. By failing to pay
attention to details, they may miss key points. Often co-occurs with dyslexia.
Frequently associated with dyslexia, students may have difficulty understanding when listening, expressing
themselves clearly using speech, reading, remembering instructions, understanding spoken messages and
staying focused.
Autistic spectrum: autistic characteristics such as Asperger syndrome, can co-exist with the conditions described
above. Those affected often demonstrate unusual behaviours due to inflexible thinking, over-reliance on
routines, a lack of social and communication skills.
Some common characteristics of SpLDs:

Memory difficulties.
Organisational difficulties.
Writing difficulties.
Visual processing difficulties.
Reading difficulties.
Auditory processing difficulties.
Time management difficulties.
Sensory distraction: an inability to screen out extraneous visual or auditory stimuli.
Sensory overload: a heightened sensitivity to visual stimuli and sound; an inability to cope with busy
environments.
Visual Stress.

Some pupils with dyslexic difficulties may experience visual disturbance when reading:
Text can appear distorted and words or letters appear to move or become blurred.
There may be difficulties tracking across the page.
White paper or backgrounds can appear too dazzling and make print hard to decipher.
Good lighting can help overcome some visual problems and in particular the avoidance of white boards
and white paper. Coloured filters can help settle down visual disturbance.
For further information follow this link to Eyes and Dyslexia.
http://www.bdadyslexia.org.uk/educator/what-are-specific-learning-difficulties
INDICATIONS, HINTS AND TIPS: PRE-SCHOOL
Handy Hints for Educators Working with Pre-School Aged Children.
1. Introduction.
2. Indicators.
3. Children at Risk.
4. Resources.
1. Introduction.
There is a large body of research linking speech and language difficulties in early childhood to later literacy
problems. Because much can be done pre-school to help a child at risk, early identification is really important.
Although some children may have difficulties with some parts of their learning, they are just as bright and able
as their peers - in some cases even brighter! They are often creative and imaginative. At the same time they also
have difficulties. If a child shows a cluster of difficulties, you will need to take action. (Return to top)
2. Indicators.
Here are some hints on identification. The list is worth keeping handy - the chances are there's at least one
dyslexic child in each nursery class.
Watch out for the child who does not outgrow the following possible indicators:-

has difficulty learning nursery rhymes;

finds difficulty paying attention, sitting still, listening to stories;
likes listening to stories but shows no interest in letters or words;
has difficulty learning to sing or recite the alphabet;
has a history of slow speech development;
gets words muddled e.g. cubumber, flutterby;
has difficulty keeping simple rhythm;
finds it hard to carry out two or more instructions at one time, (e.g. put the toys in the box then put it on
the shelf) but is fine if tasks are presented in smaller units;
forgets names of friends, teacher, colours etc.;
poor auditory discrimination;

finds difficulty cutting, sticking and crayoning in comparison with their peer group;
has persistent difficulty in dressing, e.g. finds shoelaces and buttons difficult;
puts clothes on the wrong way round;
has difficulty with catching, kicking or throwing a ball;
often trips, bumps into things, and falls over;
has difficulty hopping or skipping;
has obvious 'good' and 'bad' days for no apparent reason.
(Return to top)
3. Children at Risk.
A child who has a cluster of these difficulties together with some abilities may be dyslexic, but remember that
the levels of development and speed of learning at the pre-school stage differ significantly for each child.
If you find at risk children, consult with the special needs advisor. There are programmes and games to help
with development in speech and language, motor skills, auditory and visual perception and memory.
4. Resources.
Dyslexia: Early Identification (BDA)
http://www.bdadyslexia.org.uk/educator/pre-school-hints-and-tips

INDICATIONS, HINTS AND TIPS: SECONDARY

The information contained on this page is specific aimed at secondary school aged children
1. Written Work.
2. Reading.
3. Numeracy.
4. Other areas.
5. Behaviour.
6. Practical Aids
We have all come across the situation. A young person struggling with aspects of reading, writing, spelling and
perhaps numeracy. The learner who is struggling, despite clear ability in specific aspects of the curriculum. For
some there may be slight improvement in time, but for many there will not. Your experience tells you that there
is something different about this learner, that he/she needs specific support for learning in order to meet obvious
potential. Normal provision is not helping. So, what is their problem? Who can help? How do you know
whether or not a particular adolescent may be dyslexic? What should you look for?
Dyslexia is a combination of abilities as well as difficulties. It is the disparity between them that is often the
give-away clue. The person who, despite certain areas of difficulty, may still be creative, artistic, sporting or
orally very able and knowledgeable. However, alongside these abilities, will be a cluster of difficulties individual for each person.
1. Written Work.
Has a poor standard of written work compared with oral ability;
Has poor handwriting with badly formed letters;

Has neat handwriting, but writes very slowly indeed;

Produces badly set out or messily written work, with spellings crossed out several times;
Spells the same word differently in one piece of work;
Has difficulty with punctuation and/or grammar;
Confuses upper and lower case letters;
Writes a great deal but 'loses the thread';
Writes very little, but to the point;
Has difficulty taking notes in lectures;
Difficulty with organisation of homework;
Finds tasks difficult to complete on time;
Appears to know more than can be committed to paper.
(Return to top)
2. Reading.
Is hesitant and laboured, especially when reading aloud;
Omits, repeats or adds extra words;
Reads at a reasonable rate, but has a low level of comprehension;
Fails to recognise familiar words;
Misses a line or repeats the same line twice;
Loses his place - or uses a finger or marker to keep the place;
Has difficulty in pin-pointing the main idea in a passage;
Finds difficulty with dictionaries, directories, encyclopaedias.
(Return to top)
3. Numeracy.
Finds difficulty remembering tables and/or basic number sets;
Finds sequencing problematic;
Confuses signs such as x for +;
Can think at a high level in mathematics, but needs a calculator for simple calculations;
Misreads questions that include words;
Finds mental arithmetic at speed very difficult;
Finds memorising formulae difficult.
4. Other areas.
Confuses direction - left/right;
Has difficulty in learning foreign languages;
Has indeterminate hand preference;
Has difficulty in finding the name for an object;
Has clear processing problems at speed;
Misunderstands complicated questions;
Finds holding a list of instructions in memory difficult, although can perform all tasks when told
individually.
5. Behaviour.
Is disorganised or forgetful e.g. over sports equipment, lessons, homework, appointments;
Is immature and/or clumsy;
Has difficulty relating to others: is unable to 'read' body language;
Is often in the wrong place at the wrong time;
Is excessively tired, due to the amount of concentration and effort required.

If you see a cluster of difficulties together with abilities in specific areas, the young person may be
dyslexic.Your next step should be to consult the school Special Needs Co-ordinator (SENCo) immediately and
be given appropriate and immediate support.
6. Practical Aids.
Whiteboards and whiteboard markers
Highlighters
Post-it Notes
Pastel coloured paper/exercise books
Coloured overlays and reading rulers
Write and Wipe Pockets
Wooden letters: upper and lower case.
HINTS AND TIPS: FE & HE
University Disability Officers offer specialist advice about all aspects of support. Dyslexic students should
contact their Disability / Student Support Office as soon as they accept a place.
1. Disabled Students Allowances.
2. Open University.
3. Nursing Students.
4. Funding.
5. Help with Finding a Job.
1. Disabled Students Allowances.
In order to access support at Higher Education, a student will need to show an assessment report post 16 years
from either a Psychologist registered with the Health Care Practitioner Council HCPC, or a specialist dyslexia
teacher with an SpLD Diploma in Further/Higher Education and an assessment Practising Certificate.
Dyslexic students in Higher Education, who have been assessed as dyslexic, can apply to their funder (e.g.
Student Finance England, NHS Student Grants Unit) for a DSA. Part time students and post-graduate students
are now eligible for this allowance.
The DSA is available for courses lasting at least 1 year at Higher Education registered with Student Finance
England where the student is eligible for Student Finance. If you are not eligible for Student Finance, you
cannot apply for the DSA. However your university should provide appropriate support.
HNC (1 year courses).
HND (2 year courses).
Foundation Degrees (2 year courses).
Certificate of Higher Education.
Degrees , Masters and PhDs.
Post Graduate Certificate of Education (PGCE).
Initial Teacher Training.
Further Training of Youth & Community Workers.
It takes, on average, over 10 weeks from applying for DSAs to receiving support. For the latest information
from Student Finance see: http://www.slc.co.uk/stakeholders-partners/latest-news.aspx
Students at Higher Education with dyslexic difficulties can apply for the Disabled Students Allowance. The
application should be supported by a diagnostic assessment report post 16 years from either an Educational
Psychologist with a Health Professional Council (HPC) Practising Certificate, or a specialist dyslexia teacher
with a Practising Certificate.

If you are eligible for a DSA, you can go to an ACCESS Centre, which can assess the needs of disabled
students including ICT.
Provision under the DSA for dyslexia can include once only equipment, such as a PC, hardware and appropriate
assistive software, including ICT training; study skills support from a specialist tutor; proof reading, and an
annual general allowance for books etc. See Bridging the Gap, below, for full details.
2. Open University.
Disabled Student Services.
Tel: 01908 653 745
Email: disabled-student-resources@open.ac.uk
Web: http://www.open.ac.uk/disability/ou-disability-contacts.php
3. Nursing Students.
The NHS operates separate support for Disabled Students:
Tel: 0845 358 6655.
Web: http://www.nhsbsa.nhs.uk/Students/969.aspx
4. Funding.
The Educational Grants Advisory Service (EGAS)
EGAS offers guidance about loans, grants and benefits from educational trusts and charities for disadvantaged
students over 16. Send a stamped address envelope or phone for a form for completion, to enable EGAS to give
you appropriate advice.
Address:
The Educational Grants Advisory Service (EGAS)
501-505 Kingsland Road,
London
E8 4AU.
Tel: 020 7254 6251. (only taking calls on Wednesday, Thursday 2pm - 4 pm)
Fax: 020 7249 5443.
Please note that phone line is
Scholarship Search UK.
Academic Scholarships and Bursaries for UK Universities and Educational Institutions.
Web: http://www.scholarship-search.org.uk
5. Help with Finding a Job.
EmployAbility,an organisation providing the essential link for disabled and dyslexic students and graduates to
ease the transition from education to employment, giving free guidance and advice on internship and graduate
opportunities with top employers, as well as recruitment processes including how to seek disability related
adjustments.
http://www.bdadyslexia.org.uk/educator/hints-and-tips-fe-he